Breast Lump Flashcards
Define metaplasia
Interchangeable change from one mature cell type to another typically in response to trauma
this is NOT cancer and is NOT pre-cancerous
define dysplasia
disordered function and maturation/differentiation of a tissue
part of the journey from normal to cancer - this IS premalignant
define neoplasia
the presence or formation of new, abnormal growth of tissue
define heritability
the extend to which observed differences are due to genes
diseases associated with smoking
- mutagenic (cancer)
- inflammation (COPD)
- nicotinic receptors (high BP and heart rate)
- Endothelial damage
CO levels - intrauterine growth retardation
What is neoadjuvant treatment
chemotherapy is given before the surgery to:
- treat early metastatic disease
- reduce extend of surgery - better functional and cosmetic result
examples:
- breast cancer
- oesophageal cancer
- osteogenic sarcoma
What is adjuvant treatment?
chemotherapy given after surgery to reduce risk of recurrence
not a guarantee of cure
what is palliative treatment
- Not curative.
- May help with symptoms due to cancer.
- Balance of toxicity and benefit really important.
- Not all patients will respond.
- Some tumour types more sensitive than others
Define hyperplasia
increased number of cells
this is also NOT cancer and it can combine with metaplasia
Define hypertrophy
increase in cell size which may increase size of the tissue
e.g. exercise causes biceps to increase
Define oncogene
An oncogene is a gene that pushes towards growth when you don’t want it to
tumor suppressor genes suppress these
What is meant by benign?
it cannot pass the basement membrane - therefore won’t infiltrate adjacent tissues
Potential problems with twin studies
- Monozygotic twins share more ‘environment’ than dizygotic twins
- Monozygotic twins may not have shared same uterine environment
what are the consequences of the metabolism of alcohol?
- Acetaldehyde - carcinogenesis
- Increases oestrogen levels
- Decreases NAD levels - alters lipid metabolism
- Reactive oxygen - damages lipid membranes
- Decreases vitaminB levels
- Depresses CNS function
- Teratogenic
What is quantitative inheritance?
Complex disorders & continuous traits, are influenced by multiple genes and multiple environmental factors
what is the liability threshold model?
- All the factors which influence the development of a multifactorial trait/ disorder can be considered as a single entity: liability
- Liabilities of all individuals in a population form a continuous variable
- Individuals on the right side of the line represent those with the disorder
What is polymorphism?
• Any variation in the human genome that has a population frequency of greater than 1%
or
• Any variation in the human genome that does not cause a disease in its own right. It may however, predispose to a common disease. ie is a risk factor
what are some of the different subtypes of breast cancer?
– ER positive/HER-2 negative – ‘Triple negative’ – HER-2 positive – Lobular/Ductal/Metaplastic – BRCA1/2-mutated
what are the factors influencing breast surgery?
Triple assessment = clinical, pathological and radiological
What is crucial to remember about chemotherapy?
• Mutations allow resistance to treatment.
• Heterogenous with regard to cell cycle: cancer stem cells
• Blood supply essential
• Many cytotoxic drugs are
cell cycle specific
Features of chemotherapy
- Time between doses allows normal tissues to recover (gut & marrow).
- Pulsed intermittent therapy - cycles.
what do the targeted treatments for cancer target?
– Antibodies – Immunomodulants/ hormone modulation – Gene therapy – Growth factors – Differentiation agents – Small molecule tyrosine kinase inhibitors
What are the side effects of chemotherapy?
- tumour lysis syndrome
- bone marrow side-effects
- GI side effects: nausea, loss of appetite, constipation, diarrhoea, mucositis
- fatigue
- body image side effects
peripheral neuropathy
What are the risk factors of breast cancer?
age family history previous breast cancer/lump dense breast tissue hormones (e.g. HRT) obesity alcohol radiation
